Tramadol, a synthetic opioid analgesic prescribed to treat moderate to severe pain, is considered a safer alternative to other narcotic analgesics like hydrocodone (Vicodin, Lortab) and methadone.

Additional medications containing tramadol include Ultram ER, an extended release formulation for round-the-clock pain relief, and Ultracet, a combination of tramadol and acetaminophen (Tylenol).

Tramadol is also known as a Central Nervous System (CNS) depressant which dulls or eliminates the sensation of pain signaled to the brain. This is the light face, the face that brings relief and makes one feels there was never pain.

Good as the pharmacodynamic effect of this drug may be, the “Dark Face” when it’s abused can be heart rending, tears dropping, relationship breaking, home shaking, and hopes dashing.

Watching a friend, son of a wonderful mentor or teacher, family member abuse drugs can be very upsetting to say the least, more so losing a fellow youth to the cold hands of death. My heart bleeds for the young men wasting purpose and ambitions on the pangs of Tramadol.

The title, “Dark Face” portrays the gloominess on the faces of parents and relations when you announce to them that the ‘feel good’ Tramadol is the cause of the closish death of  their wards.

It depicts the resignation to the grave of hopes, dreams, ambitions, passions, talents, untapped potentials and resources, leadership and innovations to mention a few, all because of an ‘abuse’, abusing the wrong thing, Tramadol.

The Dark Face illustrates the form of helplessness felt by the abusers of tramadol as relations, parents, and friends who though weeping for their misfortune, blame them for the consequences of their choices which ultimately could be death.

This ugliness respects nobody and affects the rich and poor alike, the elites and non-elites, the proud and humble, the high and low, the armed and unarmed, as well as children and adults.

This publication is borne out of the loss of two young vibrant lives, who presented to me within a four (4) week period, to Tramadol.

First case was that of a 12 year old primary school pupil, the  son of an officer in the Nigeria Police Force, who knew how to inject the Tramadol parenterally through his veins. This is quite indicting on the professional stand of the parent and to think that the son of an officer would have had the prerogative to do so is quite disturbing.

I have also seen the son of a Professor in Medicine lose his mind to substance abuse. I can’t forget the cases of senior medical personnel who abuse hard drugs themselves, one that readily comes to mind was that of a medical doctor in the level of a Senior Registrar who almost lost both lower limbs to substance abuse.

These instances no doubt may serve as eye opening and head bowing facts to parents who would have thought that a subset of the population are immune to this occurrence.

The second case that presented to me was that of a 17-year-old male, who fell in the bathroom after having a good dose of Ultram and became unconscious probably secondary to some intracranial bleeds.

His parents kept him at home not knowing the cause of the sudden fall, hoping he would get better until his condition started to worsen.

We later gathered that though he had not advanced as in the first case but he used soft drinks for the solvent base of the opiate.

On that fateful day he had dissolved at least ten (10) capsules in a soft drink and drunk the solution. I subsequently had some discussions with several people in a quest of fact finding and found that this latter method is popular than the former however.

He was the son of one of the rich men in the community, yet wealth couldn’t save his life; poverty wouldn’t have done any better.

These are the few in this short period who were so unlucky and my heart bleeds at the thought of others who lose jobs, quit relationships, separate from family, isolate from well meaning friends, join up with evil companies just because of this scourge.

Habitual users who become tolerant to Tramadol need to increase the amount or frequency of the doses they ingest in order to achieve the previously euphoric effects, this eventually drags them to “accidental overdose”.

Symptoms and signs include Miosis, difficulty with breathing, intense drowsiness, cold and clammy extremities, slow and/or irregular heart rate, collapsed or clogged blood vessels, nausea, vomiting, constipation, seizure, loss of consciousness, and coma among others.

Behaviors that indicate addiction are not far fetched as these individuals have cravings, need more of the drugs to achieve usual effect, use the drugs for non-medical purposes and are unable to control use.

Additional signs of addiction are persistent drug use despite awareness of physical and/or psychological harm, drug seeking behavior, doctor shopping, poor performance at work or school for no other reason but drug-related impairment, neglecting friends and family in order to use or obtain drugs.

Sufferers from addiction can’t just “walk away” from the troubles (side effects and possible near fatal effects of accidental overdose) in their life, “oh to find a better day”,like the singer Craig David puts it.

They also suffer for attempting to let go, but with expert psychological, spiritual, and pharmacological treatment modalities, it can be said that, the Egyptians whom ye have seen today, ye shall see them again no more forever.

Some of the withdrawal symptoms include gastrointestinal pain, diarrhea, depression, agitation, confusion, numbness in the extremities, ringing in the ears, hallucinations, and paranoia.

Management and helping of sufferers from Tramadol addiction will include Psychological e.g Motivational Interviewing (MI), CAGE-AID and CRAFFT screening tools; Alternative treatment for Pain; Tapering of doses taken; Low dose Benzodiazepines. This must be however under the guideline of the various experts.

Emergency management will employ the Respiratory support mechanism, Oxygen therapy, Intravenous fluids, opioid antidotes like Naloxone or Naltrexone, among others that may be available to the managing facility or receiving physician.

As they say ‘prevention is better than cure’. I hope that this little piece will educate the youths and even adult age groups who find this habitual and also increase the awareness of this in our communities.

I wish to lead a Non-Governmental Organization that will go to the urban and rural communities, in collaboration with experts from various fields of Toxicology to hold town hall meetings with risk groups, the Youths, identify with and engage them on a nation saving agenda. Yeah, looks tough, but with Mandela’s, “it’s always impossible until it’s done”.

We never know in our lifetimes the full impact of our influence and actions, great or small. We have a responsibility to find, perform, and complete our purposes so that we can make a positive and lasting contribution to our generation. This is without doubt why Barr. Kabiru Bala of Daily Trust Media has chosen to sponsor this publication, my unreserved gratitude to you sir.

In conclusion, an analogy from the lives of the Oyster and the Crab shows how Tramadol captures her Victims. When the moon is full, the Oyster completely opens, and the crab on seeing this, throws a piece of stone or sea weed into it so that the oyster cannot close again and it serves the crab for meat. Such is the fate of him that allows a little vain indulgence to lure him into taking this inevitably progressive life taking adventure should nothing be done to forestall the imminent Dark Face.

Together let us say NO to Substance Abuse, NO to TRAMADOL

Imieni Odijie
Imieni Odijie
(IT Consultant for VGADA)

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